By the age of 19, up to 25% of people will have faced depression. The teenage years are formative years for everyone, and it is not a surprise that these years may be filled with confusing and hard-to-deal with emotions. To make matters worse, most teens fail to receive the proper cognitive behavioral therapy (CBT) treatment due to a lack of access to mental healthcare and fear of stigma. Researchers in New Zealand have attempted to solve this issue by creating alternative solutions of CBT to youth and adolescent patients. As face-to-face CBT treatment is deemed as awkward by young patients due to the social interaction component, computerized CBT development has undergone much improvement to provide a lower cost, easier-to-access mental healthcare alternative that is fun for patients.
Sally Merry, associate professor at University of Auckland, led the research team of New Zealand to develop SPARX—the computerized CBT treatment to help patients fight depression. SPARX (Smart, Positive, Active, Reality, X-Factor thoughts) is a first-person interactive game where players create avatars and fight GNATs (Gloomy, Negative, Automatic thoughts) that plague the game world. With seven levels and each of the levels lasting for about 45 minutes, SPARX attempts to teach patients how to deal with emotions more effectively with a computerized interface rather than seven face-to-face CBT sessions. To show the accuracy and detail that went into the design of such healthcare game, here is a brief overview of the seven levels:
- Finding Hope—“Psychoeducation about depression and an introduction to the cognitive behavioral therapy model; discussing how hope is key to fighting depression. Learned Skill: Controlled Breathing”
- Being Active—“Activity scheduling and behavioral activation. Learned Skill: Communication and interpersonal skills”
- Dealing with Emotions—“How to deal with anger and hurt feelings. Learned Skill: Effective assertiveness, listening, and negotiation”
- Overcoming Problems—“Problem solving using STEPS: Say the problem, Think of solutions, Examine the pros and cons, Pick one and try it, See what happens”
- Recognizing Unhelpful Thoughts—“Recognizing different types of GNATs”
- Challenging Unhelpful Thoughts—“How to change negative thoughts for positive ones”
- Bringing it All Together—“Recap of all skills and how to tolerate distress and know when to ask for help”
Gamification and healthcare is not a new topic, but it is one that is still in its early stages. However, the success of SPARX has shown yet again that the combination between healthcare and video games is an epic win. In a trial experiment consisting of 187 patients aged 12-19, 94 subjects received SPARX treatment while the other 93 received regular CBT treatment for a period of 4-7 weeks. The results measured were the change in responses or score on the children’s depression rating scale, the Reynolds adolescent depression scale, the mood and feelings questionnaires, the Kazdin hopelessness scale for children, and other mental psychology scales. None of these measures showed SPARX to be inferior to usual treatment. In addition to being comparable to the regular, as usual treatment, patients who participated in computerized CBT treatment by playing SPARX showed a significant difference in improvement of depression on the Kazdin hopelessness scale for children and the mood and feelings questionnaire.
Success in the trial experiment does not necessarily guarantee SPARX to be an effective method of helping tackle depression. However, it is a huge step forward that does call for celebration and recognition. As advances continue to be made in the field of gamification and healthcare, we should hope to see more easier-to-access healthcare methods. Games like SPARX empower players to embrace and engage their illness in a positive, learning environment so proper steps can be taken to help cure patients of that illness.